儿童先天性肠旋转不良的超声诊断价值

目的 探讨儿童先天性肠旋转不良的超声诊断价值.方法 回顾分析73例先天性肠旋转不良患儿的术前声像图表现,评价超声诊断的敏感性和特异性.结果 声像图表现为：（1）胃、十二指肠扩张70例（95.89％）；（2）下消化道肠管呈塌瘪状58例（79.45％）；（3）肠系膜血管呈螺旋状盘曲52例（71.23％）；（4）肠系膜上动脉（SMA）与肠系膜上静脉（SMV）位置关系异常14例（19.18％）；（5）肠管囊性团块8例（10.96％）；（6）肠套叠2例（2.74％）.声像图显示肠系膜血管呈螺旋状盘曲对诊断中肠扭转的敏感性为87.72％、特异性为87.50％,对中肠扭转的阳性预测价值为96.15％.结论 中肠扭转的声像图表现具有特征性.肠旋转不良的声像图表现与病理类型有关,提高对该病的病理类型及其超声表现的认识,有助于提高术前诊断率.

Value of ultrasound diagnosis in children with congenital intestinal malrotation

Objective To investigate the value of ultrasound diagnosis in children with congenital intestinal malrotation.Methods We analysis the ultrasound feature of 73 patients with congenital intestinal malrotation retrospectively,and evaluate the sensitivity and specificity of the ultrasound diagnosis.Results Ultrasound feature were including：（1） gastric,duodenal dilatation in 70 cases （95.89％） ; （2） small intestine of lower digestive tracts were empty,with no liquid or gas in 70 cases （79.45％） ; （3） mesenteric vessels had ＂spiral＂ sign in 52 cases （71.23％） ; （4） superior mesenteric artery （SMA） and superior mesenteric vein （SMV） malposition in 14 cases （19.18％） ; （5） thick-walled cystic mass in 8 cases（10.96％） ; （6） intestine invagination in 2 cases（2.74％）.The ＂helical winding＂ of mesenteric vascular was the characteristical ultrasound diagnosis of midgut volvulus,of which the sensitivity and specificity were 87.72％ and 87.50％ respectively,and the positive predictive value was 96.15％.Conclusions The ultrasound feature of midgnt volvulus are characteristically.The relationship of ultrasound findings and pathologic types of intestinal malrotation are important to preoperative diagnosis and need more forward study.